Danielle Steilen-Matias, PA-C | Katherine Worsnick, PA-C | Ross Hauser, MD | David Woznica, MD

We are here to help! Please use this form to ask any questions and to see if you are a candidate for our treatments. Let’s get started—tell us about your pain challenges:

1. Contact Information:
First Name: *
Last Name: *
E-mail: *
Phone: *
Address:
City:
State/Providence:
Zip:
Country:

2. Tell us a bit about your case:

Current diagnoses by another healthcare provider:

Primary medical concern you would like to inquire about: *

Current level of athletics and/or daily activities: (ie: marathon training, manual labor, etc..)

3. How can we best serve you?
Are you looking for more information on our specialties?
I am interested in ProlotherapyI am interested in Stem Cell TherapyI am interested in Platelet Rich PlasmaI am looking for a potential alternative to surgeryI am interested in Digital Motion X-ray in Florida
Are you interested in an appointment?
Yes, at the Oak Park, Illinois officeYes, at the Fort Myers, Florida office
as soon as possiblewithin a couple weekswithin 1-2 monthsnot sure
Contact Preference: Do you have a preferred contact method so we can talk with you more about your case?
Please call meI’d prefer email
How did you hear about us?
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Thank you for considering Caring Medical Regenerative Medicine Clinics for Prolotherapy. With two locations: one in Oak Park, Illinois, and one in Fort Myers, Florida, Caring Medical has developed into one of the largest Comprehensive Prolotherapy Clinics seeing patients from all over the world!

SEARCH
for your symptoms

• Surgery
• NSAIDs
• Cortisone Shots
• R.I.C.E.